Prevalence of Peristomal Dermatitis-Related Pain: A Cross-Sectional Study

Peristomal skin complications affect a significant proportion of individuals living with urinary or fecal stomas, with peristomal dermatitis being the most common. Dermatological changes such as erosion, pruritus and pain are critical symptoms impacting the patients' quality of life. The purpose of this manuscript is to analyze the prevalence of peristomal dermatitis-related pain and the associated factors in patients treated in specialized outpatient clinics.

This is a secondary, epidemiological, observational, cross-sectional, and correlational study, with data extracted from a previously published primary study.

Data collection instruments included sociodemographic and clinical data forms, the Numerical Rating Scale (NRS) for assessing the intensity of pain, and the DET® Score for evaluating the severity of peristomal dermatitis. Regression analyses were done to determine the factors associated with the presence of peristomal dermatitis-related pain. Both the primary and secondary studies were approved by a Research Ethics Committee.

One hundred and nine adults with intestinal and urinary stomas and peristomal skin complications were enrolled in the study. Most participants were male (59/54.1%), with colostomies (58/53.2%). The most common complication was moisture-associated peristomal dermatitis (79/72.5%). The prevalence of peristomal dermatitis-related pain was 33.9% (37/109). The DET® Score was the only variable associated with the presence of "pain at the consultation" (0.6346; p < .001) and the "worst pain during the week" (0.535; p < .001), indicating that each point on the DET® Score increased consultation pain by 0.6 and the worst pain during the week by 0.5.

The study demonstrated that peristomal dermatitis-related pain was present in over one-third of the sample, increasing with the severity of the lesion. Then, care efforts must be taken by health professionals, mainly nurses, in preventing peristomal dermatitis, and consequently, pain and suffering.

The study highlights the importance of a comprehensive patient assessment beyond the immediate clinical presentation of the peristomal skin lesion, including the quantitative and qualitative assessment of nonvisible signs and symptoms such as pain, itching, and burning. Stomatherapists and nonspecialized nurses can use this information to develop individualized care plans that incorporate pain management strategies during and after the change of the collection device. In addition, the association between peristomal skin damage and pain severity emphasizes the need for nurses and patients to monitor skin conditions with preventative measures as part of a pain prevention strategy. This approach can improve peristomal dermatitis - related pain outcomes and increase patients' quality of life.